Sentinel lymph node metastasis diagnosis using ultrasound plus magnetic resonance lymphangiography in breast cancer.

Background: Ultrasound diagnosis is a highly specific tool and widely applied, but is associated with low sensitivity in detection of sentinel lymph nodes (SLNs). The diagnostic value of routine ultrasound combining magnetic resonance lymphangiography (MRL) for the detection of SLNs in breast cancer metastasis is still unclear. This study used ultrasound combined with MRL to explore the diagnostic value of detecting SLN metastasis in breast cancer.

Methods: This study included female breast cancer patients who received modified radical mastectomy at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between January 2016 and January 2019. The gold standard of SLNs is pathological results. The patients were divided into three groups: (I) Group A: an ultrasound plus MRL (contrast agent injected outside the areola) group; (II) Group B: an ultrasound plus MRL (contrast agent injection around the areola) group; and (III) Group C: an ultrasound plus MRL group (this group comprised patients from the two aforementioned groups).

Results: A total of 432 patients were included. The overall detection rate and overall diagnostic accuracy of SLNs in breast cancer differed significantly among the three groups (all P<0.05). Ultrasound plus MRL showed a best overall detection rate 56.02%, and a best diagnostic accuracy 95.83%. The detection rate and diagnostic accuracy of axillary SLNs varied markedly among the three groups (P<0.05). The detection rate and diagnostic accuracy when the internal mammary node was the SLN differed notably between the ultrasound plus MRL (contrast agent injected outside the areola) and ultrasound plus MRL (contrast agent injection around the areola) groups and between the ultrasound plus MRL (contrast agent injection around the areola) and ultrasound plus MRL groups (all P<0.05).

Conclusions: Ultrasound plus MRL may be advantageous for the detection of SLN metastasis in breast cancer and predicting breast cancer prognosis.